Electrocardiogram mounting method

ABSTRACT

In an apparatus for mounting portions or segments of an electrocardiographic tape upon a medical history record sheet, the sheet is fixedly supported upon a shiftable platen, with the electrocardiographic tape being transversely moved there-across in a superposed relationship until that portion of the tape which depicts a significant graphical segment of the heartbeat is focused in a viewer, at which time a punch and die combination function to sever that segment of the tape and immediately deposit it upon the surface of the record sheet. In the process of performing this function, the record sheet is shiftable in both the lateral and longitudinal directions until that surface portion of the sheet to which a segment of the tape is to be mounted is arranged directly under the punch, at which time the punch may be actuated either electrically, mechanically, or manually, to sever the tape and immediately affix that severed segment to the record sheet.

United States Patent [191 Larson [451 Jan. 14,1975

[76] Inventor: Paul U. Larson, 6214 Washington Ave., St. Louis, Mo. 63130 [22] Filed: Mar. 13, 1973 [21] Appl. No.: 340,825

Related US. Application Data [62] Division of Ser. No. 161,731, July 12, 1971, Pat. No.

Primary ExaminerDouglas J. Drummond Attorney, Agent, or Firm-Paul M. Denk 57 ABSTRACT In an apparatus for mounting portions or segments of an electrocardiographic tape upon a medical history record sheet, the sheet is fixedly supported upon a shiftable platen, with the electrocardiographic tape being transversely moved there-across in a superposed relationship until that portion of the tape which depicts a significant graphical segment of the heartbeat is focused in a viewer, at which time a punch and die combination function to sever that segment of the tape and immediately deposit it upon the surface of the record sheet. In the process of performing this function, the record sheet is shiftable in both the lateral and longitudinal directions until that surface portion of the sheet to which a segment of the tape is to be mounted is arranged directly under the punch, at which time the punch may be actuated either electrically, mechanically, or manually, to sever the tape and immediately affix that severed segment to the record sheet.

1 Claim, 6 Drawing Figures PATENTEDJAHMIBYS $860,474

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GENERAL HOSPITAL DATE 59 SA! NT LOUIS MISSOURI PATIENT ADDRESS DIAGNOSI3 PATENTEU JAN 1 4ls7s SHEET 3 OF 3 ELECTROCARDIOGRAM MOUNTING METHOD CROSS REFERENCE TO RELATED APPLICATION The subject matter of this application is related to and comprises a division of Ser. No. 161,731, filed July 12, 1971 now US. Pat. No. 3,755,047 which issued on Aug. 20, 1973, upon an electrocardiogram mounting apparatus.

BACKGROUND OF THE INVENTION This invention relates to a mounting apparatus, and more particularly facilitates the severing of an electrocardiographic tape so that select portions of the same may be immediately deposited onto a medical record sheet in a unitary operation.

To provide some background respecting the development of the present invention, it is of value to provide a very brief summary of the electrocardiogram for the purpose of enhancing an understanding of the utility of this invention. The electrocardiogram provides a tape that is exposed to at least one stylus that electrically connects to approximately ten sensors that are adhered to the surface of particular areas of the body. Each sensor records electrical impulses of the functioning of the heart as recorded at these various remote locations of the body, and by manipulating a dial, the operator can effect selective recording upon the tape from one particular sensor at any time. Generally, there are usually ten such sensors that are applied to the body, and the operator of the electrocardiogram will consecutively record upon the tape a record of the heartbeat as observed consecutively by these ten sensors. Once and E.l(.G. has been acquired, it is then usually the duty of a hospital technician to cut certain segments from the tape, usually 12 portions, which provide the best representation of the record made from the discreet sensors, and these segments of the tape are then hand mounted upon a medical record sheet to provide a readily accessible history of the heart of the patient. Obviously, the process of selecting portions of the E.K.G. tape and cutting the same for subsequent mounting is a rather time consuming operation in any hospital, clinic, or medical office having a large number of clientele, so therefore, an apparatus that will facilitate this entire operation is a desirable addition to this particular art.

Numerous apparatuses have been devised for use in other fields for achieving the cutting of labels, stamps, or other material from a tape and then affixing the same to some form of a carrier, article, or other member. These apparatuses are mainly designed to their own specific configuration to function and achieve a result in their particular provincial art, and would not, as a practical matter, be employable for achieving automatic mounting of select segments of the electrocardiographic tape upon a medical record sheet.

While others have been confronted with the problem of excessive time consumption that occurs when numerous E.K.G. tapes must be continuously mounted upon record sheets, as in the hospital, their solutions to this problem have not effectively automated the process of performing this function, nor do they incorporate the precision that is necessary to provide personal medical history charts that are entirely accurate. For example, Cardiosonics Medical Instruments Corporation, of Belmont, Massachusetts, has devised an ECG mounter which functions through the use of a cutter to cut sections, either individually or a plurality of sections, simultaneously from a tape, and then said sections are manually positioned after gluing upon a mounting guide where upon a roller is employed to adhere said segments upon an adhesive surface of a medical chart. While this mounter is a step towards easing the tedious process of preparing E.K.G. history charts for patients, it still requires the use of a significant amount of manual dexterity and time in both the cutting of the tape and subsequently applying adhesive arranging and mounting these cut-out segments to a chart. Furthermore, where this prior art device encourages multiple cutting and stacking of the cardiographic tape for a simultaneous cutting of all sections of the tape, such a procedure usually entails a significant amount of time on the part of the technician to make sure that the most desirable segments of the tape are superimposed one upon the other to ensure accuracy of interpretation of the heart functioning of the patient. Where the cutout segments are individually produced, the operator must manually draw the tape across the cutter to punch out the particular sections desired to be mounted, before each section is the individually hand carried to a guide for positioning over the medical chart.

The present invention greatly improves upon the rudimentary concepts disclosed in the aforesaid prior art device, and achieves a more effective automation in the process of mounting segments of an E.K.G. tape to a medical chart.

It is the principal object of this invention to provide an apparatus for automatically severing and mounting a plurality of electrocardiographic charts or segments cut from a E.K.G. tape upon a medical record sheet.

It is another object of this invention to provide an apparatus having a cooperating punch and die combination that includes a viewer through which the technician may observe the E.K.G. tape and instantaneously actuate the apparatus for simultaneous severing and mounting of that selected portion of said tape onto a medical history sheet.

A further object of this invention is to provide a moveable platen for holding a medical history sheet, which platen may be quickly shifted both laterally and longitudinally to provide immediate location of a certain surface portion of the medical history record beneath the tape in preparation for reception of a segment of said tape.

It is yet another object of this invention to provide a method for adhering select portions of an E.K.G. tape to a medical history chart that is totally automated wherein both the cutting and mounting functions may be achieved simply through the energization of an operating solenoid, or the like.

Other objects will become more apparent to those skilled in the art in light of the following summary, description, and accompanying drawings.

SUMMARY OF THE INVENTION As previously reviewed, the only devices available for facilitating the preparation of a medical report incorporating the results of an electrocardiogram test are simply mechanical devices that assist in the cutting of such tape, or provide a guide to the mounting of portions of the tape onto a history blank. The object of this invention is to consolidate into one complete operation the ability of the technician to observe the tape, select its most pertinent segments, and then in a unitary operation sever a segment of the tape and simultaneously mount it upon the history chart, all done in substantially an automatic operation.

To achieve results of the foregoing, this mounting apparatus incorporates a base member which has substantial stability and includes both a member for holding a medical record sheet firmly in place, and a tape guiding and cutting means which allows for passage of the tape just above the record sheet. The technician employs a viewer, which comprises part of the tape guiding means, and therein can select the most desirable segments of the tape to be mounted upon the sheet, with said guiding means also being adapted for cutting tape segments while simultaneously mounting the same upon the sheet. Since it is necessary that the record sheet be repeatedly adjusted so as to dispose parts of its surface for reception of each separate segment cut from the E.K.G. tape, the sheet, in addition to its holding member, are adjustable in both lateral and longitudinal directions so the technician may promptly readjust the disposition of the sheet to a new location just after one segment of the tape has been applied onto one sector of the sheet. While the description of this invention discusses the manueverability of its sheet holding member, it is just as likely that said member may be maintained stationary, and the tape guiding and cutting means could be mounted in such a manner so as to provide for its readjustment in both a lateral and longitudinal directions to dispose the E.K.G. tape over various sectors of the medical record sheet in order that segments of said tape may be mounted upon the same.

Automation is incorporated into this mounting apparatus in that tape guiding means incorporates cutting elements that are in the nature of a punch and die combination so that when a particular segment of the tape that is desired to be mounted comes into view, a solenoid, or any other energy producing means, may be actuated to cause the punch to move relative to its die and thereby cut a segment of the tape with the punch continuing a further downward movement for the purpose of acting as a press for mounting said cut segment onto the record sheet. For the convenience of its operator, the punch of this apparatus is formed having a central cavity in which is mounted a viewer, such as of glass or other prism for the purpose of enhancing the inspection of the tape passing through the guide, and to provide a direct view of that segment of the tape which shall be cut and mounted onto the record sheet when the apparatus is triggered by the technician. While the apparatus is defined as being operated through the use of a solenoid, it is just as likely that a hand lever could be employed and be manually actuated for both cutting the tape segment, and pressing it onto the sheet.

BRIEF DESCRIPTION OF THE DRAWINGS In the drawings, FIG. 1 provides a perspective view of the mounting apparatus showing both the medical record sheet secured in place with the roll of E.I(.G. tape traversing there across;

FIG. 2 provides a longitudinal sectional view taken along the line 2-2 of FIG. 1;

FIG. 3 provides a similar view to FIG. 2 but showing the actuating means operating the cutting means for severing a segment of the tape and mounting it upon the surface of the medical record sheet;

FIG. 4 provides a top plan view of the mounting apparatus as disclosed in FIG. 1;

FIG. 5 is an exploded view of the sheet holding member, or platen, raised from its guides and stop means as formed on the base member; and

FIG. 6 provides a partial longitudinal sectional view taken along the line 66 of FIG. 4, showing the tape guide and cutting means.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to the drawings, and in particular to FIGS. 1 and 4, reference character A generally depicts the mounting apparatus of this invention which includes a base member 1 comprising substantially a pair of longitudinal rails 2 which are formed integrally structurally with a pair of upper arms 3, and providing intermediate said rails 2 and arms 3 a slot 4 of substantial longitudinal depth to provide clearance for freedom of movement of the sheet holding member 5 of this invention. The rearward portion of this apparatus may incorporate the usual cover plates 6 to enhance the appearance of the apparatus, and provide closure for the instrumentalities that automate the functioning of the same.

An E.K.G. tape guiding and cutting means 7 is disposed intermediate the forward extremities of the arms 3, and by referring to FIGS. 2, 3 and 6, it can be seen that this means comprises a pair of support blocks 8 and 9 which are securely mounted to the inner sides of said arms 3, and furnish guidance for the vertical movement of the punch-press combination that functions to sever select portions of the tape upon actuation of the apparatus. The punch is formed having a central cavity thereview, as at 10a, so that the tape can be seen through the same. Connecting to the downward side of the support blocks 8 and 9 are a pair of spacers II that are of sufficient depth and spaced apart that distance which allows for clearance for movement of the E.K.G. tape therethrough, a portion of which is shown at 12. Secured to the downward side of the spacers I1 is the die portion 13 of the tape cutting device, and it can be easily seen that the opening 14 through the die is of a dimension which allows for the snug movement therethrough of the punch 10 so that a segment of the tape arranged thereat may be severed, and that this severed segment of the tape may be forced further downwardly to be press mounted upon the medical record sheet 15 that is arranged upon the sheet holding member 5. For purposes of illustration, a cut segment 16 of the tape is shown already mounted upon the surface of the record sheet, as are other segments of the tape that have already been mounted.

The instrumentalities to provide actuation of the punch with respect to its die are also shown in FIGS. 2 and 3, wherein a solenoid 17 is shown mounted upon a base 18 that extends between the rails in the rear portion of the base member I. A first link 19 pivotally connects to the core of the solenoid at one end, while at its other end the link connects to a bell crank means 20. One side of 21 of said means pivotally connects to the upper arms 3 of the apparatus, while the other side 22 of said crank means attaches with a connecting rod 23 that pivotally mounts between the rear portion of the base member 1, as at 26. The forward ends of said arms 25 and 24 are additionally mounted, as at 27, to the upward portion of the punch 10 of the tape cutting means. Thus, it can be seen that when the solenoid 17 is deenergized, and the apparatus remains inactive, as shown in FIG. 2, the core of the solenoid will be extended from its coil under the bias of the tension spring 28, which stabilizes the punch in its upwardmost position. On the other hand, when the solenoid 17 is energized thereby withdrawing its core within its coil, the link 19 will be attracted rearwardly, thereby causing the bell crank 20 to draw the connecting rod 23 and arms 25 and 26 slightly downwardly, resulting in the punch 10 being urged into downward movement through the spacing 29 in which the tape 12 is disposed, and additionally downward through its mating die 13 for the purpose of achieving a severing of a portion of the tape and compressing it against the sheet 15 for its attachment thereto.

The sheet holding means of this invention is more aptly disclosed in FIGS. 4 and 5, wherein the platen 30 is mounted for lateral sliding movement upon a supporting plate 31, which supporting plate is arranged for longitudinal sliding movement upon the longitudinal rails 2 of the base member. Each rail 2 is formed having an outwardly projecting portion 32 which is designed to accomodate for sliding movement the mating inturned edges 33 of the support 31. The forward and rearward edges of the support 31, only the forward edge 34 being herein shown for purposes of illustration, extend slightly beyond the length of the edges 33, and these forward and rearward edges of the support 31, only the forward edge 34 being herein shown for purposes of illustration, extend slightly beyond the length of the edges 33, and these forward and rearward edges of this support are designed for embracement by the inturned edges 35 and 36 of the platen 30. Thus, lateral sliding movement of the platen 30 can be thereby acquired with respect to its support 31. To define limits to the lateral movement of the platen with respect to its support, the support is designed having a projecting finger 37 which engages with the compressed portion 38 of the platen, so that movement of the platen in the direction until it encounters finger 37 forms its limits of shifting in the right direction, while the shifting of the platen to the left will eventually cause the contact of said portion 38 with the left inturned edge 33 of the support 31, thereby defining the limit to the movement of the platen to the left. These limits to the lateral of the platen have been predesigned in such a manner so that the medical records sheet held by the platen, when the platen has reached its various limits of movement, will readily dispose certain sections of the sheet surface under the tape cutting means, these particular segments 39 of the sheet being more aptly disclosed in FIG. 4. It should also be noted in this figure that edge grips 40 are provided upon the upper surface of the platen so that the sheet 15 may be guided and held firmly in place upon the surface of the same.

To provide longitudinal or depth adjustment to the platen 30 of this apparatus, a stop means including a detent 41 is arranged for insertion within a series of aligned aperatures 42 provided in the underside of the support 31. This detent 41 is secured to a hand lever 43 that is pivotally mounted at one end, as at 44, to the rail 2, while the other end of said lever projects beyond the end of the platen 30, and in particular beyond the end of any record sheet 15 that may be affixed upon said platen. It is desirable to have this hand lever 43 extend beyond said sheet, as shown at 45 in FIG. 4, so that the technician can readily depress the lever for disengaging of its detent 41 from the support 31, to allow for prompt readjustment of the platen and support in preparation for reception of another cut segment of the tape onto the record sheet 15 at a precise location. A spring 46 is held in place to the underside of the lever 43, and is likewise compressed thereagainst by its mounting to the boss 47 that projects from the side of the proximate.

The operation of this mounting apparatus is regulated to a simplified operation since the cutting of the E.K.G. tape and its adherence to the medical record sheet is achieved automatically in one step. The tape, in its roll form, as shown at 48 in FIG. 1, is mounted upon a spindle 49 that is supported upon a rail 50 extending laterally from the base member 1. The tape 12 is then guided through the slot 29 provided in the tape guiding means, and the exposed end of the tape extending from said slot may then either be rolled upoon a second spindle (not shown) for the hand winding of the tape, or said tape may simply be pulled therethrough and left to dangle into a waste depository. The operator may view the tape through the central cavity 10a provided through the punch 10, for the purpose of observing that particular'desired portion or segment of the tape that is to be severed and mounted onto the medical sheet 15. Although it is not shown, the cavity 51 of this punch may incorporate a magnifying glass or other prism for the purpose of amplifying or clarifying the visual picture of the tape seen therethrough. When the operator has pulled the tape through the guide means and has arrived at that segment of the tape to be mounted, an actuating device (not shown) comprising either a push botton or a foot manipulated switch may be depressed to energize the solenoid 17, to effect the type of movements as previously described in the description of FIGS. 2 and 3. Through this operation, the punch will sever a segment of the tape and immediately push this severed portion further downwardly for mounting onto the recordsheet. Some form of adhesive or pressure sensitive type of adhesive means may be provided upon the surface of the record sheet 15 so that the cut segment of the tape may be firmly adhered thereto. Following this, the operator may simply manipulate the hand lever 43, depressing it downwardly, so as to release its detent 41 from within the supporting plate 31, so that both the support 31 and the platen 30 may be quickly manipulated to expose one of the sections 39 of the sheet 15 within the viewer of the punch 10 so that an additional segment of the drawn tape may be likewise severed and mounted onto the surface of the record sheet. It can be seen both in FIGS. 1 and 5 that the spent portion of the tape 15 has various segments cut out of it, as at 52, and thatthese cut out segments of the tape form the charts that have been just previously mounted onto the upper surface of the medical record sheet shown, while the downward portions of said sheet expose various adhesive filled portions that are ready to receive other particular segments of the E.K.G. tape in a like manner.

Numerous variations in the construction and opera tion of this mounting apparatus, within the scope of the appended claims, will probably occur to those skilled in the art in the light of the foregoing disclosure. The above description is merely illustrative of one embodiment of the apparatus.

Having thus described the invention, what is claimed and desired to be secured by Letters Patent is:

sheet until the desired segment is aligned for severing and immediate deposition upon the record sheet, severing said tape to free the designated segment of the tape for its immediate descent for deposition and adherence to a specific location on the underlying sheet, and adhering said segment at a designated location on the sheet to provide a permanent medical record of at least one cardiographic reading. 

1. In the method of sequentially applying and mounting a plurality of segments of an electrocardiographic tape in an orderly pattern to a medical record sheet comprising fixing the sheet upon a slidably mounted platen and in a position just below where at least one segment of the tape will be positioned, adjusting the platen in two directions to arrange the sheet into position to receive a designated segment of said tape, passing the tape in an overlying relationship across the sheet until the desired segment is aligned for severing and immediate deposition upon the record sheet, severing said tape to free the designated segment of the tape for its immediate descent for deposition and adherence to a specific location on the underlying sheet, and adhering said segment at a designated location on the sheet to provide a permanent medical record of at least one cardiographic reading. 